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    穴透刺联合口服丁苯酞胶囊对大脑中动脉狭窄CT脑灌注成像及血管活性物质的影响

    Effect of penetrating acupuncture combined with oral butylphthalide capsule on CT cerebral perfusion imaging and vasoactive substances in middle cerebral artery stenosis

      摘要
    • 摘要:
      目的探讨穴透刺联合口服丁苯酞胶囊对大脑中动脉(MCA)狭窄CT脑灌注成像及血管活性物质的影响。
      方法选取单侧MCA狭窄病人60例为研究对象，根据随机数表法分为观察组与对照组，每组30例。2组病人均采用基础治疗(拜阿司匹林100 mg+氯吡格雷片75 mg+阿托伐他汀钙20 mg联用)，观察组在此基础上增加头穴透刺联合丁苯酞治疗。所有入组病人治疗前后行CT灌注成像(CTP)，测量并计算脑血容量(CBV)、脑血流量(CBF)、平均通过时间(MTT)和达峰时间(TTP)及相对灌注参数，即rCBV、rCBF、rMTT、rTTP值；采集治疗前后空腹静脉血行血管活性物水平检测，包含一氧化氮(NO)、内皮素-1 (ET-1)、血栓素B2 (TXB2)、血管紧张素Ⅱ(AngⅡ)、血管内皮生长因子(VEGF)。
      结果治疗后，观察组各CTP参数与治疗前相比差异均有统计学意义(P < 0.05~P < 0.01)，观察组CBV、CBF指标均显著高于对照组，MTT、TTP、rMTT指标均显著低于对照组(P < 0.05~P < 0.01)，对照组治疗前后差异无统计学意义(P>0.05)；治疗后，2组血管活性物与治疗前相比均差异均有统计学意义(P < 0.05)，其中观察组NO、VEGF水平显著高于对照组，ET-1、TXB2、AngⅡ水平显著低于对照组(P < 0.05~P < 0.01)。观察组不良反应发生率6.67%，与对照组的16.67%比较差异无统计学意义(P>0.05)。
      结论头穴透刺联合丁苯酞可改善MCA狭窄病人脑血流动力学状态，有效调节血管活性物质的水平，促进早期新血管形成，保护脑组织。

       

      Abstract:
      ObjectiveTo investigate the effect of penetrating acupuncture combined with oral butylphthalide capsule on CT cerebral perfusion imaging and vasoactive substances in middle cerebral artery (MCA) stenosis.
      MethodsA total of 60 patients with unilateral MCA stenosis were selected as the study subjects.They were randomly divided into the study group and the control group according to the random number table method, with 30 patients in each group.Both groups received basic treatment (baiaspirin 100 mg+clopidogrel tablet 75 mg+Atorvastatin calcium 20 mg), and the study group added head acupoint penetration combined with butylphthalide treatment on this basis.CT perfusion imaging (CTP) was performed for all enrolled patients before and after treatment.Cerebral blood volume (CBV), cerebral blood flow (CBF), mean passage time (MTT), peak time (TTP) and relative perfusion parameters (rCBV, rCBF, rMTT and rTTP) were measured and calculated.Fasting venous blood samples were collected before and after treatment to measure the levels of vasoactive substances, including nitric oxide (NO), endothelin-1 (ET-1), thromboxane B2 (TXB2), angiotensin Ⅱ (AngⅡ) and vascular endothelial growth factor (VEGF).
      ResultsAfter treatment, the CTP parameters in the study group were significantly different from those before treatment (P < 0.05 to P < 0.01), the indexes of CBV and CBF in the study group were significantly higher than those in the control group, while the indexes of MTT, TTP and rMTT were significantly lower than those in the control group (P < 0.05 to P < 0.01).There was no significant difference in the control group before and after treatment (P>0.05).The levels of NO and VEGF in study group were significantly higher than those in control group, while the levels of ET-1, TXB2 and Ang Ⅱ were significantly lower than those in the control group (P < 0.05 to P < 0.01).There was no significant difference in the incidence of adverse reactions between the observation group(6.67%) and control group (16.67%)(P>0.05).
      ConclusionsHead acupoint penetration combined with butylphthalide can improve the state of cerebral hemodynamics in patients with MCA stenosis, effectively regulate the level of vasoactive substances, promote the early formation of new blood vessels, and protect brain tissue.

       

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